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EASLES  IN  MICHIGAN 


DURING  THE  YEAR  ENDING  DECEMBER  31,  1890. 


REPORT  COMPILED  FROM  REPORTS  TO  AND  CORRESPONDENCE  OF 
THE  OFFICE  OF  THE  SECRETARY  OF  THE 
STATE  BOARD  OF  HEALTH. 


sprinted  from  the  Nineteenth  Annual  Report  of  the  Secretary  of  the  Michigan  State  Board  of 

Health,  for  the  Fiscal  Year  ending  June  30,  1891. 


Reprint  No.  383. 


MEASLES  IN  MICHIGAN. 


DURING  THE  YEAR  ENDING  DECEMBER  31,  1890. 


[  Reprinted  from  the  Annual  Report  of  the  Michigan  State  Board  of  Health  for  the  year  1891. J 

[  Reprint  No.  883.  ] 

There  were  reported  to  the  Secretary  of  the  State  Board  of  Health  in 
all  421  outbreaks  of  measles,  in  407  local  jurisdictions,  as  having  occurred 
in  Michigan  during  the  year  1890;  and  in  these  outbreaks  there  were 
reported  to  have  occurred  11,911*  cases  and  140*  deaths.  For  the  preced¬ 
ing  year,  1889,  there  were  reported  only  2,899  cases  and  28  deaths  in  148 
local  jurisdictions.  Each  year  the  State  Board  of  Health  is  making  more 
effort  to  get  local  health  officials  to  take  measures  to  prevent  the  spread  of 
measles,  and  to  make  reports  to  this  office  concerning  that  disease  in  their 
localities,  and  it  is  probable  that  a  larger  proportion  of  the  actual  numbers 
of  cases  and  deaths  were  reported  in  1890  than  in  1889. f  But  the  princi¬ 
pal  reason  why  there  were  so  few  cases  and  deaths  from  measles  reported 
in  1889  is  that  measles  runs  in  waves,  the  maximum  crests  of  which  are 
about  7  or  8  years  apart,  and  a  trough  between  two  waves  of  measles  fell 
in  the  year  1889.  This  may  be  seen  by  referring  to  Table  1,  and  the 
accompanying  diagram. 


TABLE  1. — Exhibiting  the  reported  number  of  deaths  from  measles  per  100,000 per¬ 
sons  living  in  Michigan  in  each  of  the  24  years,  1869-91.  Compiled  from  the  Secre¬ 
tary  of  State's  Vital  Statistics  of  Michigan.  ( Population  estimated  by  average 
annual  increase,  by  Dr.  Wilbur,  Chief  of  Vital  Statistics  in  State  Department.) 


Year. 

1868. 

1869. 

1870. 

1871. 

1872. 

1873. 

1874. 

1875. 

1876. 

1877. 

1878. 

1879. 

_ /_ 

Deaths.  . . . 

8.66 

12.88 

4.72 

5.45 

14.12 

18.56 

3.37 

9.50 

8.10 

4.13 

1.03 

10.49 

Year. 

1880. 

1881. 

1882. 

1888. 

1884. 

1885. 

1886. 

1887. 

1888. 

1889. 

1890. 

1891. 

Deaths _  _  ... 

7.63 

15.21 

8.68 

14.54 

7.91 

2.04 

6.75 

14.56 

20.62 

5.08 

10.94 

10.51 

*  Only  the  37  cases  which  died  were  reported  from  the  city  of  Detroit.  If  in  that  city  the  deaths  were 
the  same  per  cent  of  the  cases  as  was  reported  for  the  rest  of  the  State  (.87  of  one  per  cent),  4,252  cases  of 
measles  occurred  in  that  city  during  the  year  18P0,  making  the  number  of  cases  for  the  whole  State  16,126, 
instead  of  11,911  as  given  above.  But  probably  not  half  of  the  cases  of  measles  were  reported,  as  is  evi¬ 
denced  in  the  note  following  this. 

t  Probably  not  half  of  the  cases  and  deaths  are  yet  reported  ;  this  is  evident  from  the  fact  that  for  the 
year  1890  there  were  reported  to  the  Secretary  of  State  229  deaths  from  measles;  and  it  is  well  known  that 
not  all  deaths  are  reported  to  the  Secretary  of  State.  The  Secretary  of  the  State  Board  of  Health  esti¬ 
mates  that  in  order  to  equal  the  actual  number  of  deaths,  the  reported  deaths  should  be  increased  by  forty 
per  cent.  If  this  is  done,  the  probable  number  of  deaths  from  measles  in  1890  is  found  to  be  321. 


MEASLES  IN  MICHIGAN  IN  1890. 


•239 


R  ejjorte  d  Deaths  from  JCeasles  in  <Jiichigqin9  2JJ  l/ectrs, 


Diagram  lf  graphically  represents  Jaile  1  which  Supplies  the  figure*  in  detail  . 


MEASLES  SHOULD  BE  RESTRICTED. 

As  yet  very  little  effort  is  made  in  localities  to  restrict  measles,  as  there 
is  quite  a  prevalent  but  erroneous  idea  that  measles  is  not  a  dangerous  dis¬ 
ease.  The  following  are  some  important  reasons  which  have  led  the  Mich¬ 
igan  State  Board  of  Health  to  class  measles,  for  the  purpose  of  restriction, 
with  “diseases  dangerous  to  the  public  health”:  (1)  it  is  a  communicable 
disease  and  therefore  preventable;  (2)  it  causes  more  than  two  hundred 
deaths  each  year  in  Michigan;  (3)  it  causes  several  thousands  of  easels  of 
sickness  each  year;  (4)  it  frequently  injures  or  destroys  the  organs  of  sight 
or  hearing  of  those  who  survive  the  disease1;  (5)  it  frequently  prepares  the 
way  for  and  is  closely  followed  by  pneumonia  and  consumption*;  (6)  there 
is  danger  of  measles  becoming  as  prevalent  in  Michigan  as  it  now  is  in 
England  where  it  destroys  more  lives  than  diphtheria  and  scarlet  fever 
combined,  t 

As  may  be  seen  by  Table  2,  isolation  and  disinfection  were  reported  to 
have  been  enforced  in  only  (5  of  the  419  outbreaks  of  measles;  and 
these  measures  were  both  reported  to  have  been  neglected  in  57  outbreaks. 
The  difference,  in  favor  of  isolation  and  disinfection,  is  very  marked, — the 
average  number  of  cases  per  outbreak  where  isolation  and  disinfection 
were  neglected  having. been  84.54,  and  the  deaths  .77;  and  in  the  6  out¬ 
breaks  where  these  measures  were  enforced  the  average  number  of  cases 
was  only  3.15,  and  there  were  no  deaths.  In  two  outbreaks  isolation,  only, 
was  reported  as  having  been  enforced,  and  one  outbreak  disinfection,  only, 
was  reported  as  having  been  enforced.  In  the  351  outbreaks  in  the  reports 
of  which  isolation  or  disinfection  or  both  were  not  mentioned  or  the  state- 


*  Atkinson,  in  Wood’s  Reference  Handbook  of  the  Medical  Sciences,  Vol.  IV,  p  681;  Qnain,  Dictionary 
of  Medicine,  p.927;  Ziemssen,  Cyclopedia  of  the  Practice  of  Medicine,  Vol.  II,  pp.  102-106. 

t  According  to  the  Fifty-first  Annual  Report  of  the  Registrar-General,  of  Births,  Marriages  and  Deaths 
in  England,  p.  lii, — during  the  4  years  1884-8  the  average  annual  number  of  deaths,  per  million  persons 
living,  from  scarlet  fever  and  diphtheria  combined  was  only  395,  while  from  measles  alone  it  was  577. 


240  STATE  BOARD  OF  HEALTH.— REPORT  OF  SECRETARY,  1891. 


ments  were  doubtful,  considerable  effective  work  was  apparently  done  in 
the  way  of  isolation  and  disinfection.  The  result  is  seen  by  comparing 
the  average  numbers  of  cases  and  deaths  in  this  “doubtful”  column  with 
those  in  the  column  headed  “Isolation  and  Disinfection  Neglected.”  In 
the  “doubtful”  column  the  average  number  of  cases  was  only  17.92  and 
the  deaths  .11;  in  the  “neglected”  column  the  average  number  of  cases 
was  84.54  and  the  deaths  .77.  In  other  words,  there  were  seven  times  as 
many  deaths  and  nearly  five  times  as  many  cases  in  those  outbreaks  known 
to  be  neglected,  as  in  those  outbreaks  classed  as  “doubtful”  because  the 
reports  were  not  sufficiently  definite  to  be  classed  as  certainly  “  isolated 
and  disinfected.”  If  in  the  353  outbreaks  in  the  “doubtful”  column  there 
had  been  no  isolation  or  disinfection,  it  is  probable  that  the  average  num¬ 
bers  of  cases  and  deaths  would  have  been  about  the  same  as  in  the  57  out¬ 
breaks  in  which  both  isolation  and  disinfection  were  known  to  have  been 
neglected,  or  an  average  of  84  54  cases  and  .77  deaths  per  outbreak,  or  a 
total  of  29,843  cases  and  272  deaths  in  the  353  outbreaks.  Taking  from 
these  the  6,326  cases  and  59  deaths  that  occurred,  there  remain  23,517 
cases  and  213  deaths  indicated  as  having  been  prevented  by  isolation  and 
disinfection  in  these  353  outbreaks. 

It  is  to  be  hoped  that  health  officers  will  make  all  possible  effort  to  get 
the  people  and  attending  physicians  to  cooperate  with  them  in  restricting 
measles  by  strict  isolation  and  thorough  disinfection. 


TABLE  2. — Exhibiting  the  numbers  of  Outbreaks,  Cases  and  Deaths  from  Measles 
in  Michigan  during  the  year  1890,  and  also  the  average  numbers  of  Cases  and 
Deaths  per  Outbreak  in  each  of  the  following  groups  of  Outbreaks:  ( 1 )  All  Out¬ 
breaks;  ( 2 )  the  353  Outbreaks  in  which  Isolation  or  Disinfection  or  both  were  Neg¬ 
lected  or  the  statements  were  Doubtful;  (3)  the  2  Outbreaks  in  which  only  Isolation 
was  Enforced;  (4)  the  1  Outbreak  in  which  only  Disinfection  was  Enforced;  (5)  the 
57  Outbreaks  in  ivhich  both  Isolation  and  Disinfection  were  Neglected;  and  (6)  the 
6  Outbreaks  in  which  both  Isolation  and  Disinfection  were  Enforced. 


1 

* 

u> 

All  Outbreaks.* 

(2) 

Isolation  or 
Disinfection 
not  mentioned 
or  statements 
Doubtful. 

(3) 

Only 

Isolation 

Enforced. 

(4) 

Only 

Disinfection 

Enforced. 

(5) 

Isolation 

and 

Disinfection 

Neglected. 

(6) 

Isolation 

and 

Disinfection 

Enforced. 

Outbreaks. 

OD 

0 

CD 

C3 

r  \ 

Deaths. 

Outbreaks.  | 

Cases. 

0 

CG 

0 

Q 

Outbreaks. 

Cases. 

Deaths. 

Outbreaks. 

Cases. 

Deaths. 

Outbreaks. 

Cases. 

1  Deaths, 

Outbreaks. 

Cases. 

Deaths. 

Total _ 

419 

11,189 

103 

353 

6,326 

59 

2 

17 

0 

1 

3 

0 

57 

4,819 

44 

6 

19 

0 

Average  _ 

26.70 

.25 

'  17.92 

.11 

— 

8.50 

0 

.... 

3 

0 

.... 

84.54 

.77 

3.16 

0 

*  The  number  of  outbreaks,  cases,  and  deaths  given  in  this  column  differ  from  those  given  in  the  first 
paragraph  of  this  article,  those  from  Detroit  and  Grand  Rapids  not  being  included  in  this  table,  because 
in  those  cities  measles  is  present  throughout  the  year,  and  as  the  reports  are  now  made  there  is  no  way  of 
distinguishing  separate  outbreaks. 


INFLUENCE  OF  AGE  IN  MEASLES. 

The  reports  of  local  health  officials  in  Michigan  for  the  year  1890,  gave 
the  ages  of  3,367  persons  who  were  sick  with  measles,  and  of  21  persons 


MEASLES  IN  MICHIGAN  IN  1890. 


241 


who  died  of  that  disease.  Table  3  represents,  in  certain  age-groups,  (1 ) 
the  number  of  cases  and  (2)  the  number  of  deaths  from  measles;  (3)  the 
per  cent  that  the  cases  in  each  group  were  of  all  cases  of  measles;  (4)  the 
per  cent  that  the  deaths  in  each  group  were  of  all  deaths  from  measles; 
and  (5)  the  per  cent  that  the  deaths  in  each  group  were  of  the  cases  in 
each  group  respectively, — compiled  from  all  reports  for  the  year  1890 
which  stated  the  ages. 

By  this  table  (3)  it  may  be  seen  that  the  greatest  proportion  of  cases  of 
measles  occurred  in  persons  from  5  to  10  years  of  age, — over  one-third 
(37.87  per  cent)  of  all  cases  having  occurred  in  that  period  or  age.  The 
next  highest  five-year  period  is  the  first  five  years  of  age,  “0-5.”  From 
the  second  five-year  period  the  numbers  of  cases  grade  downward,  each 
succeeding  period  being  lower  than  the  preceding  period. 

The  probable  reason  for  the  large  proportion  of  cases  in  persons  from 
5  to  10  years  of  age  is  that  a  larger  proportion  of  children  commence 
going  to  school  in  that  period  than  at  any  other  (the  schools  being  centers 
of  infection  in  localities  where  cases  of  measles  are  not  strictly  isolated); 
and  that  a  large  proportion  of  persons  in  the  later  age-periods  are  pro¬ 
tected  by  having  had  measles  in  earlier  ages. 

By  Table  3  it  may  also  be  seen  that  the  greatest  proportion  of  deaths 
occurred  in  the  first  five-year  period,  over  half  of  all  deaths  (57.1  per 
cent)  having  occurred  in  that  age-period;  and  of  these  five  years  the  great¬ 
est  proportion  of  deaths  (23.8  per  cent  of  all  deaths  from  measles)  occurred 
in  the  second  year  of  age. 

The  last  line  of  this  table,  giving  the  per  cent  the  deaths  in  each  group 
were  of  the  cases  in  each  group  respectively,  is  perhaps  the  most  import¬ 
ant  one.  When  the  data  for  several  years  can  be  combined  in  a  line  like 
this,  it  will  go  far  towards  settling  the  question  as  to  the  age  in  which  there 
is  least  danger  of  a  case  of  measles  proving  fatal  in  Michigan.  The  data 
for  the  one  year/ 1890,  indicate  that  there  is  greatest  danger  of  a  case  prov¬ 
ing  fatal  during  the  first  five  years  of  age,  and  that  there  is  least  danger 
from  about  5  or  10  to  25  or  30  years  of  age, — the  per  cent  of  cases  proving 
fatal  having  been:  in  children  under  5  years  of  age,  1.54;  in  persons  from 
5  to  25,  .29;  and  in  persons  from  25  to  55,  1.14. 

There  is  an  erroneous  and  very  harmful  belief,  quite  prevalent  among 
parents,  that  measles  cannot  ultimately  be  escaped  any  more  than  teeth¬ 
ing,  and  that  the  least  dangerous  time  for  persons  to  have  the  disease  is 
while  quite  young  children, — the  reverse  of  the  facts  as  shown  above.  As 
a  result  of  this  mistaken  belief  there  is  frequently  presented  the  shocking 
spectacle  of  a  mother  deliberately  exposing  her  young  child  to  measles, 
like  the  devoted  but  deluded  Indian  mother  who,  in  tears,  consigns  her 
babe  to  the  “sacred  river”  Ganges,  to  become  food  for  crocodiles,  in  the 
vain  belief  that  it  is  best  for  her  child.  The  following,  quoted  from  the 
report  of  Dr.  G.  C.  H afford,  health  officer  of  the  village  of  Manistique, 
relative  to  the  difficulties  which  he  encountered  in  endeavoring  to  restrict 
an  outbreak  of  measles  in  that  village  is  an  instance  illustrating  the  force 
of  this  mistaken  belief,  and,  in  this  respect,  his  report  is  representative  of 
the  reports  of  many  health  officers:  “Many  people,  wanting  children  to 
have  measles  while  small,  would  intentionally  expose  them.” 

31 


242  STATE  BOARD  OF  HEALTH.— REPORT  OF  SECRETARY,  1891. 


TABLE  3.— Exhibiting,  in  certain  Age-Groups ,  the  number  of  Cases  and  the  number 
of  Deaths  from  Measles;  the  per  cent  that  the  Cases  in  each  group  were  of  All  Cases , 
the  per  cent  that  the  Deaths  in  each  group  were  of  All  Deaths;  and  the  per  cent  that 
the  Deaths  in  each  group  were  of  the  Cases  in  that  group , — Compiled  from  all 
reports  for  the  year  1890  which  stated  the  ages. 


J 

Number  and  per  cent  of  Cases  and  Deaths  in  certain  Age-groups. 

Ages  in  Groups  of 
Years . . 

& 

All 

Ages. 

1 

o 

• 

W 

1 

vH 

OO 

1 

CM 

3-4, 

1 

. 

HO 

A 

5-10. 

10-15. 

15-20. 

20-25. 

25-30. 

HO 

Ot 

<i 

cc 

O 

£ 

40-45. 

'09A*f 

50-55. 

No.  of  Cases . 

8,363 

84 

143 

156 

191 

205 

779 

1,275 

639 

318 

179 

71 

54 

28 

11 

10 

2 

Per  cent  the  cases 
in  each  group 
were  of  all  cases. 

100 

2.49 

4.25 

4.64 

5.68 

6.09 

23.16 

37.91 

19.00 

9.46 

5.32 

2.11 

1  61 

0.83 

- 

0.33 

0.30 

0.06 

No.  of  Deaths  . .  . 

21 

3 

5 

3 

0 

1 

12 

3 

1 

2 

1 

0 

0 

1 

0 

1 

0 

Per  cent  the  deaths 
in  each  group 
were  of  all  deaths 

100 

14.3 

23.8 

14.3 

0 

4.8 

57.1 

14.3 

4.8 

9.5 

4.8 

0 

0 

4.8 

0 

4.8 

0 

Per  cent  the  deaths 
in  each  group 
were  of  cases  in 
that  group _ 

0.62 

3.57 

3.50 

1.92 

0 

0.49 

_ J 

1.54 

0.24 

^ _ 

0.16 

0  63 

0.56 

y 

0 

V. 

0 

3.57 

0 

10.00 

0 

1.54 

.29 

-y 

1.14 

SOURCE  OF  CONTAGIUM  OF  OUTBREAKS  OF  MEASLES. 

Of  the  419  outbreaks  of  measles  reported  to  this  office,  as  having 
occurred  in  the  year  1890,  the  local  health  officials  reported  relative  to  the 
source  of  contagium  in  ways  which  may  be  summarized  as  follows: — 
Traced  to  a  former  case,  146;  probably  traced  to  a  former  case,  3;  unknown. 
91;  not  reported,  179. 


TABLE  4. — Reported  Source  of  Contagium  of  Outbreaks  of  Measles  in  Michigan 

during  the  year  1890. 


Source. 

i 

Numbers 

of 

Outbreaks. 

Traced  to  a  former  case  .  . . .  .  _  _ 

146 

Probably  traced  to  a  former  case  .  __  . .  _  .  . - 

3 

Unknown  (includes  9  reported  “epidemic”) _  _ _ 

91 

Not  stated  .  .  .  _  -  .  _  _ _ _  - 

179 

All  outbreaks  _  _  _ _ _  _  _ 

419 

MEASLES  IN  MICHIGAN  IN  1890. 


243 


TABLE  5. — First,  second ,  and  third  localities,  where  the  second  locality  was  infected 
with  measles  from  the  first,  and  the  third  was  infected  from  the  second;  and  the 
numbers  of  cases  and  deaths  from  measles  in  the  first ,  second,  and  third  localities . 
( Compiled  from  reports  of  health  officers  who  were  able  to  trace  the  source  of  con- 
tagium  to  other  localities.) 


In  First 
Locality. 

Secondary  Localities 
infected  from 
Primary. 

In 

Second 

Locality. 

CO 

<D 

CD 

cd 

o 

Deaths. 

Cases. 

Deaths. 

Berrien  county: 

1 

0 

Galien  village _ 

1 

0 

Van  Buren  county: 

* 

— 

Hartford  village  .... 

3 

0 

Hillsdale  county: 

2 

0 

Litchfield  village . 

63 

0 

f Calhoun  county: 

Clarence  township _ 

7 

0 

Jackson  county: 

303 

2 

Spring  Arbor . 

1 

0 

Hillsdale  county: 

Litchfield  village _ 

1 

0 

Calhoun  county: 

100 

2 

Homer  township _ 

5 

0 

fCass  county: 

Silver  Creek  township. 

9 

0 

Volina  township . 

50 

0 

3 

0 

Van  Buren  county: 

_  Hartford  village _ 

1 

0 

Gratiot  county: 

500 

5 

Alma  village _ 

8 

2 

Crawford  county: 

* 

---- 

Grove  township _ 

5 

0 

Lenawee  county: 

* 

.... 

Rome  township _  ... 

1 

0 

Genesee  county: 

* 

— 

Clayton  township _ 

6 

0 

Gladwin  county: 

❖ 

.... 

Billings  township _ 

6 

0 

Grand  Traverse  county: 

* 

.... 

Long  Lake  township.. 

2 

0 

Gratiot  county: 

* 

— - 

Newark  township _ 

2 

0 

Hillsdale  county: 

22 

0 

Moscow  township . 

8 

0 

Houghton  county: 

❖ 

.... 

Adams  township _ 

275 

0 

Keweenaw  county : 

2 

0 

Sherman  township _ 

13 

0 

Huron  county: 

21 

0 

Bad  Axe  village .  _ 

17 

0 

Sanilac  county: 

300 

10 

Forester  township _ 

20 

0 

Ingham  county: 

* 

Meridian  township.. 

9 

0 

* 

.... 

Webberville  village  ... 

100 

1 

Primary  Localities 
from  which 
Measles  Spread. 


Berrien  county: 
Galien  township. 

Berrien  county: 
Lake  township.. 


Branch  county: 
Butler  township 


Calhoun  county: 
Albion  city _ 


Calhoun  county: 
Homer  village. 


Cass  county : 
Dowagiac  city. 


Clinton  county: 

St.  Johns  village. 

Crawford  county: 
Grayling  city _ 


Eaton  county: 
Eaton  Rapids. 


Genesee  county: 
Flushing  village _ 

Gladwin  county: 

Grant  township _ 

Grand  Traverse  county : 
Traverse  City . 


Gratiot  county: 
Fulton  township. 

Hillsdale  county: 
Hillsdale  city _ 


Houghton  county: 
Calumet  village. 


Houghton  county: 
Red  Jacket  village. 


Huron  county: 
Meade  township. 


l 


Sand  Beach  village 


Ingham  county: 
Lansing  city.. 
Mason  city _ 


Tertiary  Localities 
infected  from 
Secondary. 


In  Third 
Locality. 


CD 

0) 

CO 

cd 

U 


Huron  county: 
Sheridan  township 


22 


00 

c3 

0> 

A 


*  This  outbreak  was  not  reported  to  this  office  by  the  health  officer  of  the  “  first  ”  locality  at  the  time 
it  occurred. 


244  STATE  BOARD  OF  HEALTH.— REPORT  OF  SECRETARY,  1891. 


TABLE  5. — Continued. 


Primary  Localities 
from  which 

Measles  Spread. 

In  First 
Locality. 

Secondary  Localities 
infected  from 
Primary. 

In 

Second 

Locality. 

Tertiary  Localities 
infected  from 
Secondary. 

In  Third 
Locality. 

CD 

o> 

CD 

cO 

u 

0D 

-G 

co 

<D 

A 

CD 

£ 

co 

CD 

CO 

<L 

P 

CD 

Q) 

GD 

C0 

o 

XI 

eS  I 
ffi  I 

A 

Ionia  county: 

Mecosta  county: 

Mecosta  county; 

< 

Otisco  township _ _ 

* 

... 

Morley  village..  _ 

51 

1 

Aetna  township... 

25 

0 

Iasbella  county: 

Midland  county: 

Mt.  Pleasant  city _ 

* 

Coleman  village.. . 

1 

o 

1 

Jackson  county: 

Lenawee  county: 

Jackson  city _ 

* 

.... 

Ogden  township . . 

1 

0 

I 

Kalkaska  county: 

Kalkaska  county: 

Kalkaska  county: 

Kalkaska  village _ 

* 

_ _ 

Rapid  River  township. 

51 

1 

Cold  Spring  tp _ 

7 

0 

Orange  township _ 

21 

0 

f  Baraga  county : 

Midville  village _ 

16 

0 

Eaton  county: 

Kent  county: 

Charlotte  city _ 

21 

0 

Grand  Rapids  city., 

754 

3 

1 

Kent  county: 

Walker  township _ 

8 

c 

• 

Muskegon  county: 

Whitehall  village..... 

2 

0 

Manistee  county: 

Manistee  county: 

Cleon  township _ 

❖ 

Morilla  township. .  ... 

14 

0 

Mecosta  county: 

Mecosta  county: 

Deerfield  township.... 

15 

0 

Morley  village . . 

2 

0 

Midland  county: 

Midland  county: 

Midland  city... . . 

* 

Lee  township 

11 

0 

1 

Montcalm  county: 

Montcalm  county: 

! 

McBride  village _ 

* 

.... 

Ferris  township _ 

75 

l 

■ 

Montcalm  county: 

Wayne  county: 

Greenville  city . . 

* 

.... 

Northville  village _ 

1 

0 

f  Muskegon  county: 

i  No.  Muskegon  village.. 

40 

0 

Muskegon  county: 

Whitehall  village . 

1 

0 

Muskegon  city _ 

225 

2 

1 

1 

|  Wexford  county: 

t.  Wexford  township.... 

1 

0 

Oakland  county: 

Lapeer  county : 

Oxford  township . 

* 

.... 

Metamora  township... 

13 

0 

Oakland  county: 

Oakland  county: 

Lyons  township _ 

* 

Novi  township . 

1 

0 

Oakland  county: 

Livingston  county: 

South  Lyons  village... 

10 

.... 

Brighton  township _ 

5 

0 

Otsego  county: 

Ogemaw  county: 

Lake  township..  ..  _. 

* 

— 

Beaver  Lake  township. 

3 

0 

^Saginaw  county: 

Saginaw  county: 

oaginaw  county : 
Chesaning  township... 

15 

0 

1  Chesaning  village.  .... 

\  Shiawassee  county: 

24 

0 

Albee  township... 

150 

i 

New  Haven  township. . 

Saginaw  county: 

Saginaw  county: 

Merrill  village. . . 

* 

— 

Lakefield  township... 

1 

0 

*  This  outbreak  was  not  reported  to  this  office  by  the  health  officer  of  the  “first  ”  locality  at  the  time 
it  occurred. 


MEASLES  IN  MICHIGAN  IN  1890. 


245 


TABLE  5. — Continued. 


1 

4 


Primary  Localities 
from  which 
Measles  Spread. 


Saginaw  county: 
Saginaw  city... 


Saginaw  county 


Tuscola  county: 
Mayville  village. 

Van  Buren  county: 
Decatur  village.. 
Lawton  village.. 


Washtenaw  county: 
Ann  Arbor  city  ... 


In  First 
Locality. 


0Q 

0> 

CD 

a 


236 


75 

* 


Wayne  county: 
Detroit  city. 


Wayne  county: 

Van  Buren  township  .. 

Wexford  county: 
Cadillac  city . . 


Outside  the  State. 
Canada . . 


Chicago . 


New  Carlisle: 
Indiana .... 


South  Bend: 
Indiana ... 


Kansas . 

New  York  city. 


Ohio 


Marquette: 

Wisconsin 


101 


CD 

a 

03 

® 

Q 


Secondary  Localities 
infected  from 
Primary. 


Midland  county: 
Homer  township 

Clare  county: 

Hayes  township. 


Tuscola  county: 
Dayton  township. 


Van  Buren  county: 

Decatur  township. 
Porter  township _ 


fLeelanaw  county: 

Bingham  township.. 


Livingston  county: 
Unadilla  township  .. 

Macomb  county: 
Lenox  township _ 


i  St.  Clair  county: 

'  Columbus  township. 

Wayne  county: 

Bedford  township... 


Washtenaw  county: 
Superior  township .. 

Manistee  county: 
Manistee  city.. . 


Ionia  county: 

Campbell  township _ 

f  Calhoun  county: 

Burlington  township.. 

I  Mecosta  county: 

^  Aetna  township . . 

Berrien  county: 

Galien  village . 


Cass  county: 

Calvin  township. 

Oakland  county: 
Pontiac  city . 


Marquette  county: 
Michigamme  township 

Allegan  county: 
Plainwell  village _ 


,  Branch  county: 
Coldwater  city. 


Lenawee  county: 
Morenci  village. 


Baraga  county: 
Baraga  township. 


In 

Second 

Locality. 

Tertiary  Localities 
infected  from 
Secondary. 

00 

© 

X 

CC 

r  ■> 

Deaths. 

20 

0 

• 

8 

0 

3 

0 

1 

0 

75 

0 

8 

0 

50 

0 

19 

0 

20 

0 

4 

0 

3 

0 

3 

0 

• 

1 

0 

1 

0 

% 

2 

1 

1 

0 

19 

0 

/ 

150 

0 

10 

0 

2 

0 

• 

57 

0 

1 

0 

5 

0 

In  Third 
Locality. 


GO 

® 

CD 

cd 

O 


gd 

A 

cd 

® 

Q 


*  This  outbreak  was  not  reported  to  this  office  by  the  health  officer  of  the  “  first”  locality  at  the  time 
it  occurred. 


32 


246  STATE  BOARD  OP  HEALTH.— REPORT  OF  SECRETARY,  1891. 


PROPORTION  OF  MEASLES  IN  THE  DIFFERENT  MONTHS  OF  THE  YEAR  1890. 

Table  6  exhibits  the  proportion  of  measles  reported  in  each  month  of 
the  year  1890.  Theirs/  line  gives  the  per  cent  of  all  weekly  postal-card’ 
reports ,  made  by  physicians  in  active  general  practice,  which  reported  the 
presence  of  measles  under  their  observation.  The  second  line  gives  the 
average  per  cent  of  all  these  reporters  who  stated  the  presence  of  measles. 
The  third  line  states  the  average  order  of  prevalence  of  measles  in  the  list 
of  diseases  reported.  The  fourth  line  represents  the  prevalence  of  measles, 
being  a  combination  of  the  first  and  third  lines  of  this  table  (the  method 
of  combining  them  is  explained  on  pages  122-3  of  the  Annual  Report  of 
this  Board  for  the  year  1890).  In  this  third  line  the  smallest  numbers 
indicate  the  greatest  prevalence, — for  instance,  May  is  1  or  first  in  preva¬ 
lence, — more  measles  in  May  than  in  any  other  month;  June  is  2  or 
second  in  prevalence;  March  is  3  or  third  in  prevalence;  and  so  on.  The 
fifth  line  represents  by  months  the  number  of  outbreaks  of  measles 
reported  to  this  office  by  health  officers  and  clerks,  including  only  the 
reports  which  gave  the  dates  of  outbreaks, — reports  of  46  outbreaks  did 
not  give  dates  and,  of  course,  those  outbreaks  could  not  be  included  in  this 
line. 

The  evidence  in  the  various  lines  of  this  table  (6)  seems  to  indicate  that 
in  Michigan  measles  is  most  prevalent  in  the  first  half  of  the  calendar 
year,  the  maximum  occurring  about  May  or  June  and  the  minimum  about 
August  or  September.  But  this  evidence  is  only  for  a  single  year,  and 
might,  therefore,  be  exceptional.  In  Exhibit  XX.,  page  137,  of  this  Annual 
Report  for  1891,  is  a  statement  of  the  average  per  cent  of  weekly  card 
reports  stating  the  presence  of  measles  by  months  for  the  thirteen  years 
1877-89,  from  which  it  appears  that  the  maximum  occurs  in  May,  and  the 
minimum  in  October. 


TABLE  6. — Measles  in  Michigan  during  the  year  1890,  exhibiting ,  by  months,  the 
per  cent  of  all  weekly  card-reports  received  which  stated  the  presence  of  measles;  the, S 
average  per  cent  of  all  observers  reporting  weekly  who  reported  measles;  the  aver¬ 
age  order  of  prevalence  of  measles  where  it  was  present;  and  the  number  of , 
outbreaks  reported  by  health  officers  and  clerks  of  local  boards  of  health. 


1890. 

Year. 

Jan. 

Feb. 

Mar. 

Apr. 

May. 

Jane. 

Jnly. 

Aug. 

Sept. 

Oct. 

Nov. 

Dec.  ; 

Per  cent  of  weekly 
card  reports  stat¬ 
ing  presence  of 
measles . . 

12 

12 

19 

19 

21 

22 

22 

16 

5 

3 

4 

4 

7  8 

Average  per  cent  of 
observers  who 
reported  measles 
present . 

22 

18 

29 

31 

29 

35 

37 

30 

12 

7 

8 

6 

17  ! 

Average  order  of 
prevalence  where 
present . . 

3.0 

4.4 

3.2 

2.5 

2.8 

2.7 

2.9 

2.9 

4.3 

3.2 

3.3 

1.7 

2.8  | 

Prevalence  *___ . 

8 

9 

5 

3 

4 

1 

2 

6 

12 

11 

10 

7 

8  -I 

Outbreaks . . 

375 

24 

30 

45 

68 

74 

36 

27 

5 

5 

14 

18 

31  31 

*  Explained  in  the  text  accompanying  this  table. 


